HomeMy WebLinkAbout186415 TURNING CENTER FOR YOUTH & FAMILY - INSURANCE CERTIFICATEAC" " CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
llli.� 11/1/2018
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsements .
PRODUCER I CONTACT K 1 P t
Ewing -Leavitt Insurance Agency, Inc.
4090 Clydesdale Parkway
Suite 101
Loveland CO 80538
INSURED
Turning Point Center for Youth and
Family Development Inc.
1644 S. College
E: - e e ers
NE (970) 679-73355
Igo. Ext):
PFcc.karole-peters@leavitt.com
:Pinnacol
D:
(866)237-2178
22292
Fort Collins CO 80525 1 INSURER 1
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THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDL SUBR - POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE POLICY NUMBER LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE X OCCUR
ZZ4-A467318-04
11/1/2018
11/1/2019
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 100,000
X
MED EXP (Any one person)
$ 20,000
Blkt Additioinal Insured
X
X
Blkt Waiver of Subro
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L
X
AGGREGATE LIMIT APPLIES PER:
PRO
POLICY D JECT D LOC
GENERAL AGGREGATE
$ 3,000,000
PRODUCTS -COMP/OP AGG
$ included
Is
OTHER:
A
AUTOMOBILE
LIABILITY
AW4A467335 04
ll/l/2018
11/1/2019
EO aBINEDcciden SINGLE LIMIT
$ 1,000,000
X
BODILY INJURY (Per person)
$
ANY AUTO
ALL OS SCHEDULED
AUTOS AUTOS
BODILY INJURY Per accident
( )
$
HIRED AUTOS X NON -OWNED
AUTOS
X
PROPERTY DAMAGE
Per accident
$
A
X
UMBRELLA LIAB
X
OCCUR
UH4-A467319-04
11/1/2018
11/1/2019
EACH OCCURRENCE
$ 2,000,000
AGGREGATE
$ 2,000,000
EXCESS LIAB
CLAIMS MADE
DED X RETENTION 0
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
D? OFFICER/MEMBER EXCLUDE
N I A
4044167
Blanket Waiver of
10/l/2018
10/1/2019
X I PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 500,000
E.L. DISEASE - EA EMPLOYEq
$ 500,000
(Mandatory in NH)
ff yes, describe under
DESCRIPTION OF OPERATIONS below
Subrogation
E.L. DISEASE - POLICY LIMIT 1
$ 500,000
A
Professional Liability
ZZ4-A467318-04
11/1/2018
11/1/2019
Aggregate $3,000,000
Occerrence $1 , 0 0 0, 0 0 0
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: Old Town Halloween Zombie Fest - October 21, 2017. The City of Fort Collins, its officers, agents,
employees and volunteers are named as additional insured as it relates to the Old Town Halloween Zombie
Fest held on October 21, 2017. Liquor Liability $1,000,0000 limit.
City of Fort Collins
Risk Management
PO Box 580
Fort Collins, CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Karole Peters/KAPETE T a—��
U 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
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